EDITORIAL
Microsurgical anatomy of the external carotid artery:
stereoscopic study
Carlos Alberto Araujo Chagas*
Anatomy is a fundamental science for each and every medical specialty. Its apparent stagnation is associated with little awareness of its importance by the medical commu-nity. It is a dynamic science that develops along with medi-cine and surgery, and requires constant update of anatomi-cal concepts and values neglected in the past by medianatomi-cal practicioners.
Stereoscopy, in use since the sixth decade of the last century, remains as a useful tool for teaching and training on anatomy. It is widely used in surgical operations, espe-cially those requiring microscopy1.
In this context, the external carotid artery is one of the most important structures in the neck, because of its multiple branches and role in the functional approach to many structures of the neck and face. Despite the classical reports on the multiple communications between the exter-nal and the interexter-nal carotid systems, the article published in the current issue of J Vasc Bras describes the path of all its branches and most relevant anastomosis1.
Clinical and surgical use of this knowledge is not re-stricted to neurosurgery. Specialization imposes upon us the need of knowledge in depth of all aspects of funda-mental medical knowledge related to the actual practice of a specialty. Angiology and Vascular Surgery are included in this context, especially the constant study of the human anatomy.
Currently, minimally invasive procedures are fashion-able in most specialties. Angiology, Vascular Surgery and Radiology are included in these current trends.
Levels of evidence developed in international consen-sus, such as the North American Symptomatic Carotid
Endarterectomy Trial (NASCET)2, are widely used
worldwide. hey conirm the current concepts of the Guideline on the Management on the of Patients With Extracranial Carotid and Vertebral Artery Disease3 from
2011, where it is possible to ind guidelines for the use of carotid stents, besides a comparative analysis of outcomes in patients treated with stent placement and those treated by endarterectomy3.
herefore, the study of carotid artery anatomy is es-pecially important, eses-pecially for the performance of ca-rotid endarterectomy, which makes the article by Isolan et al. signiicant from the point of view of clinical-surgical applicability1.
Among the applications in the ield of Angiology and Vascular Surgery, it should be emphasized the selection cri-teria for symptomatic patients, based on the NASCET co-operative study2.
According to this trial, patients neurologically stable with carotid stenosis of 70% or more beneited from sur-gery in services where the morbi-mortality rate was less than 6%. here is strong evidence that the degree of stenosis is directly proportional to the beneit of intervention2,3.
he statement that stereoscopic images give an idea of depth, which is not achievable with conventional bidi-mensional images, is quite relevant in the discussion of this subject1.
Tridimensional perception has substantially increased in the medical literature, as well as in the media in general, and it is also well addressed in the article1.
It is expected that in the near future there will be better conditions for the understanding of tridimensional tech-niques and the use of stereoscopic images. here are also prospects for its use to increase speciic abilities of medical
*Angiologist – Rio de Janeiro (RJ), Brazil.
Master degree from Universidade Federal do Rio de Janeiro (UFRJ) – Rio de Janeiro (RJ), Brazil. Adjunct professor of Morphology at Universidade Federal Fluminense (UFF) – Rio de Janeiro (RJ), Brasil. Asssitent professor of Human Anatomy at Universidade Gama Filho (UGF) – Rio de Janeiro (RJ), Brasil.
Microsurgical anatomy of the external carotid artery: stereoscopic study - Chagas CAA J Vasc Bras 2011, Vol. 11, Nº 1
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specialists, especially those related to surgical planning and training by telesurgery.
Finally, we state at this editorial to be in consonance with the words of the editor-in-chief of J Vasc Bras, Dr. Yoshida4. He has always been in the forefront,
encour-aging the submission of articles that bring forward cur-rent data and provide an up-to-date understanding for the whole community of specialists, graduate students, and residents of Angiology and Vascular Surgery. Ater all, the advance of human knowledge is not necessarily result of new discoveries, but many times, of a new look on what is already well-known.
References
1. Isolan, GR, Pereira, AH, Aguiar, PHP, Antunes, ACM, Mousquer, JP, Pierobon, MR. Anatomia microcirúrgica da artéria carótida exter-na: um estudo estereoscópico. J Vasc Bras. 2011;10(3):xx-xx.
2. Gary, GF, Michael, E, Hugh WKB, Robert, WB. he North American Symptomatic Carotid Endarterectomy Trial Surgical Results in 1415 Patients. Stroke. 1999; 30:1751-1758.
3. homas, GB, Jonathan, LH, Suhny, A. et al. Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. Stroke. 2011; 42:e420-e463.
